cognitive behavior therapy (cbt)-based group intervention to reduce inflammation in older people with hiv

Conditions: Aging; HIV

Summary: in this study, the investigators will assess the feasibility and acceptability of an evidence-based cbt group intervention, developed for older people with hiv, and research methods in a pilot randomized controlled trial including 50 older people with hiv as participants. the evidence-based cbt intervention has been developed and utilized in three clinical groups to date initiated and led by dr. batchelder (pi) in the behavioral medicine program at mgh. the 12-week intervention program proposed leverages evidence-based traditional and contemporary cbt strategies, with the goal of improving the psychological and physical functioning of older people with hiv by providing education and support to learn strategies to: a.) better manage stressors associated with hiv and aging (e.g., multi-morbidity), and b.) increase health-promoting behaviors (e.g., physical activity).

this study is a pilot randomized controlled trial, which will include 50 older people with hiv as participants. blocks (n = 4) will be 1:1 randomized to either the group intervention or information-only control. the established 12-week group intervention consists of evidence-based traditional and contemporary cbt strategies. each week will focus on a distinct theme, including: 1.) domains of healthy aging; 2.) stress and anxiety; 3.) adherence and engagement in primary/preventative care; 4.) depression and distress; 5.) physical activity; 6.) stigma/self-compassion; 7.) substance use; 8.) acceptance of uncertainty and uncomfortable emotions; 9.) diet; 10.) behavioral activation; 11.) frailty and memory/cognition; and 12.) wrap-up and maintaining gains. all participants, including those in the intervention group and in the education-only group, will attend virtual baseline and follow-up appointments, complete computerized self-report measures (redcap) at baseline and follow-up, a structured diagnostic interview at baseline, and a blood draw appointment at baseline and follow-up. participants in the education-only group will receive a one-time brochure with information on living with hiv, healthy aging, and healthy behaviors when they attend the baseline blood draw appointment. aim 1: assess the feasibility and acceptability of an evidence-based cbt group intervention, developed for older people with hiv, and research methods in a pilot randomized controlled trial (rct). aim 2: explore changes in a.) inflammation biomarkers (i.e., interleukin-6 \[il-6\] and c-reactive protein \[crp\]), b.) psychological distress (i.e., general distress, hiv-specific stress, and depressive and anxiety symptoms), and c.) health risk behaviors (i.e., tobacco-smoking, alcohol use, sedentary behaviors, and poor diet quality) in the intervention group versus an education-only group.

Eligibility criteria:
inclusion criteria: * hiv+ with an undetectable test result within the last 12 months; willing to provide printed or online version of test result for confirmation * 50 years of age or older * on effective art; willing to provide art-related health records or prescriptions for confirmation * fluent in english (speaking and reading) * willing and able to provide informed consent * psychiatrically stable based on clinical interview exclusion criteria: -hiv- * unable to provide undetectable hiv test result within the last 12 months * not on effective art * \<50 years old * unable to read and write in english * unable to provide informed consent